cardiac posion - CVSmodule

Question 1

name some cardiac poison

Answer 1

-acotine , nicotine , digitalis

Question 2

other name of aconites

Answer 2

meetha zehar , wolf bane.

Question 3

what part of aconite plant is poisonous

Answer 3

root

Question 4

active principles of aconite

Answer 4

aconine , pesudoaconitine , aconitine.

Question 5

some aconite characteristic

Answer 5

Most posionous species are ; aconitum ferox and aconitum napellus.
root are posionous , sweet in taste no odor.
conical in shape , dark brown/white becomes pink when exposed to air

Question 6

moa of aconite

Answer 6

stimulate then paralyses peripheral termination of sensory , secretory cells , motor nerves , medulla centers , spinal cord.
depresses myocardium , smooth muscles and skeletal muscles.

Question 7

signs and symptoms of aconite

Answer 7

tingling sensation in lips, mouth , pharynx and tounge —> numbness
muscular spasm and convulsions
muscular weakness , slow and weak pulse + respiration , large dose casue arryhthmias.

ventricular fibrillation / asphyxia causes death = resp center paralysis.

Question 8

fatal dose of aconite

Answer 8

2-4gm of root , 2-6 mg of alkaloid.

Question 9

fatal period of aconite

Answer 9

1-5 hrs

Question 10

treatment for aconite toxicity

Answer 10

milk / activated charcoal , stomach wash with warm water / KMnO4 , cardiac arrythmias - 50ml of 0.1% iv novocain , artificial respiration / O2 inhalataion

Question 11

how to preserve aconite sample

Answer 11

vomitus preservation = acetic acid (1) ; rectified spirit (2)

Question 12

why aconite is ideal as homicide poisoning

Answer 12

ideal homicide = cheap , small lethal dose , easily available , difficult to detect in body coz of rapid destruction.
symptoms resemble natural disease.

Question 13

medico legal importance of aconite

Answer 13

homicidal ,accidental in Hakim Medicine , arrow poison, cattle poison , use to procure abortions.

Question 14

postmortem finding in aconite poisoning

Answer 14

not characteristic , remnant of plants may be found in stomach , brain and lung congestion , aconite is extremely unstable and rapidly destroyed by putrefaction.

Question 15

characteristics of nicotine

Answer 15

alkaloid found in tobacco plant , only ripe seeds are not poisonous , dried leaves ; 1 -8% of nicotine , active principle includes ; nicotine
and nicotianine .
colorless , volatile , bitter in taste
smoked . chewed , snuffed

Question 16

fatal dose of nicotine

Answer 16

40-60mg of nicotine , 2 gm of tobacco

Question 17

moa of nicotine

Answer 17

binds to nicotinic receptor then depolarizes autonomic ganglia -> stimulate -> paralysis of ganglia.

Question 18

nicotinic toxicity causes death by

Answer 18

early death due to vagal excitation / standstill of heart

late death –> resp failure

Question 19

treatment

Answer 19

immediate gastric lavage with KMNO4 is done , activated charcoal
initial stages -> atropine for salivation and visual disturbance.
vasodilators like nitrides , cardiorespiratry stimulants . intracardiac inj of epineprine in case of cardiac arrest , sympyomatic treatment.

Question 20

chronic poisoning of nicotine causes

Answer 20

bronchitis , pharyngitis , laryngitis , blurring or narrowing field of vision

Question 21

postmortem findings of nicotine

Answer 21

no external characteristic , internal ; signs of asphyxia , brown discoloration of wall if nicotine is swallowed , pulmonary edemas , nicotine resist petrification,

Question 22

medico legal importance of nicotine

Answer 22

accidental ; insecticide , chemical prep of fertilizers , absorbed through skin . homocidal ; rare , used as infanticide or procure abortions.

Question 23

digitalis characteristic

Answer 23

plants are poisonous but leaves are used in medicine ,active principle ; glycosides viz digitalin ,digitoxin , digitonin . cumulative action on heart. glycoside directly improves functioning of failing heart.

Question 24

fatal dose and period of digitalis toxicity

Answer 24

fatal dose ; 15-30mg of digitalin , 4 mg of digitoxin

fatal period 24hr

Question 25

signs and symptoms of digitalis toxicity

Answer 25

signs and symptoms ; nausea , vomiting and diarrhea .
mental confusion , visual disturbance , cardiac arrhythmias , conduction defects , heart block , fibrillations , drowsy , coma
hyperkalemia exacerbates condition

Question 26

treatment of digitalis toxicity

Answer 26

treatment = stomach wash with tannic acid solution , atropine for bradycardia , propanol for arrhythmias

Question 27

treatment of choice for digitalis toxicity

Answer 27

treatment of choice is immunotherapy with digitalis antibodies ( digoxin immune fab , digiband with 40 mg)

Question 28

postmortem findings of digitalis toxicity

Answer 28

external manifestation will be that of mild coma death

internally mild congestion of all organs, seed or leaves in stomach

Question 29

medico legal importance of digitalis toxicity

Answer 29

accidental , suicidal or homicidal poisoning is rare